'Elite' HIV patients mystify doctors

As many as one in 300 HIV patients never get sick and never
suffer damage to their immune systems and AIDS experts said they
wanted to know why.

Most have gone unnoticed by the top researchers, because they
are well, do not need treatment and do not want attention, said Dr.
Bruce Walker of Harvard Medical School.

But Walker and colleagues want to study these so-called "elite"
patients in the hope that their cases can help in the search for a
vaccine or treatments.

"What in the heck is going on in people that successfully
control this virus?" Walker asked a news conference held at the
16th International Conference on AIDS.

"If we can figure out how people are doing that, we can try to
replicate it."

So far Walker and colleagues have not been able to find out why
certain people can live for 15 years and longer with the virus and
never get ill. The AIDS virus usually kills patients within two
years if they are not treated.

Some even appear to have weak immune responses, he noted. "Is it
just that these people got infected with a wimpy virus? The answer
to that is no," Walker said.

"Some of the people know who infected them," he added, and in
those cases, the person who infected the "elite" patients always
went on to become ill.

A few years into the AIDS epidemic, researchers identified
people who were called "long-term non-progressors." These were
patients infected with HIV who did not become ill.

Many have become ill as the years have gone by, and required
treatment.

Walker said a few of the long-term non-progressors were now
classified as "elite" patients. But the difference is that the
"elite" status is clearly defined by how much virus they have
circulating in their blood.

Loreen Willenberg, of Diamond Springs, California, is a newly
designated "elite." Now 52 and healthy, she said she became
infected in 1992.

BAD DREAM

"I dreamed that I was HIV positive," Willenberg told the news
conference.

"I was really going through a very bad flu." She sought testing,
and after getting an inconclusive result was later declared HIV
positive.

HIV patients are not immediately put onto drugs that can keep
them healthy, but wait until the virus reaches a certain level in
the blood or until the virus kills a certain number of immune
system cells called CD4 T-cells.

Willenberg, a landscape designer, never got to that point.

"I am in perfect health. I think I have had maybe only one cold
in the past 14 years," she said.

Walker has tracked down 200 elite patients and has now joined up
with other prominent AIDS researchers to find at least 1,000
"elites" in North America and as many as possible globally.

Based on research done so far, Walker estimates there are 2,000
of them in the United States.

His team wants to take blood and DNA samples to see what might
be different about them. Confidentiality is promised.

The recently published map of the human genome will make this
possible.

They will compare key genetic sequences of the "elite" patients
to genetic readouts from healthy people and from other HIV
patients. Maybe a few genetic variations can explain what is
happening, Walker hopes.